What is a Pap Test

A PAP test is a cytological test that involves examination, under a microscope, of cells taken from the uterine cervix or vagina, as the case may be. The test was developed during the 1940's by Dr. George Papanicolaou, hence the name PAP.

A sample is taken from the outside of the uterine cervix using a wooden spatula, and then from inside the cervix using a small, harmless brush. It is quick and painless, and its purpose is to obtain cells from the external opening of the cervix, where the external stratified mucous tissue provides protection. Inside the cervix, the tissue becomes a single layer of cells and is responsible for secretions like those that occur during ovulation. Most precancerous lesions develop in this area. The cells are immediately spread over a microscope slide and treated with a fixative. For a quality specimen, it is preferable that the patient is not menstruating.

New technology - "thin layer liquid cytology" - is now available, although it is not covered by the government plan. A few private laboratories provide this test, but the client has to pay for it. It is the most sensitive test for detecting abnormalities in a low-risk population. It reduces the chances of having an unsatisfactory specimen and allows a longer time between screenings. However, the conventional screening test at the usual accepted intervals and based on your doctor's recommendations, remains very valid and has contributed to a definite decrease in the incidence of cervical cancer in countries where it is used routinely.

The specimen is examined in the laboratory and may be reported as normal, atypical, inflammatory, or showing the presence of low- or high-grade lesions. In the last two cases - and sometimes for atypical smears - the physician will recommend a colposcopy. This is a harmless, non-invasive examination during which the cervix is inspected with a microscope that enlarges from six to sixteen times. A little vinegar (5% acetic acid) is applied, so that secretions can be cleaned away and white spots can sometimes be seen.

In some cases, the physician can perform a small biopsy (or take a sample) involving very little pain, as well as scrape a small area on the inside of the cervix. A weak iodine solution is sometimes used to highlight suspicious areas.

If the test is positive for lesions, conservative treatment is generally recommended which will in no way affect fertility and the ability to carry a or deliver a child. This may be cryosurgery (freezing the cervix), laser vaporization, removal using a diathermy loop, or a cone biopsy.

Cytological tests are generally carried out annually for the first three years. If there is no lesion, they can be done every three years in the case of all women who are sexually active.

Do not hesitate to ask your doctor if you have any questions at all.

The risk of uterine cancer is very low, because of the routine screening of the uterine cervix